TEAR CARNITINE ANALYSIS AFTER CORNEAL CROSSLINKING IN KERATOCONUS

Carnitine analysis in keratoconus

Abstract

Purpose: To investigate the changes that may occur after CXL treatment in carnitine levels, which have an important role in the cell's energy cycle.

Materials and Methods: Single eye of 25 patients who underwent crosslinking (CXL) therapy for keratoconus was included in this prospective, nonrandomized study. Patients were divided into 4 different groups as male, female, over 18 and under 18 before the treatment. Tears were collected with capillary tubes before, and at the 6th postoperative month without any anesthetic agent. From the tear samples, 27 carnitine ester parameters were measured by a mass spectrometer and a ultra high performance liquid chromatograph.

Findings: The average age of patients consisting of 11 (44%) men and 14 (66%) women was 18.28 ± 3.98 years (12-25). After CXL treatment, statistically significant changes were only detected in C12 (Dodecanoil Canitine) and C14 (Myristoil Canitine) levels. Among all carnitines, only C4 and C6 carnitine levels increased, but this increase was not statistically significant. Among the age groups, the highest difference was in carnitine derivative C6, and the least differing carnitine derivative was C51 and C5DC. The carnitine derivatives that differed most in the gender groups were C6 and C16, while the least differed were C5DC and C8: 1.

Conclusion: In cases where energy needs increase, such as inflammation, there may be a decrease in inflammation severity as carnitine levels decrease. The variation between pre and post CXL carnitine level measurements in keratoconus patients can be used as a useful marker to monitor this inflammation and intervene in the event of excessive inflammation.